Radiologically guided balloon dilation of gastrointestinal strictures. Part I. Technique and factors influencing procedural success.

McLean, GK; Cooper, Gregory S.; Hartz, William H.; Burke, Dana R.; Meranze, Steven G.

doi:10.1148/radiology.165.1.3628790

Cited by 64 publications

(24 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They performed three to five sessions of balloon dilation per patient in seven patients and d ilation procedure was repeated every 3 -7 days. McLean et al (5) reported that patients dilated routinely to a lumen of 20 mm in the region of the lower esophageal sphincter required redilation every 3-4 months in order to remai n sym ptom -free Rupture is the most severe complication that can occur during the esophageal balloon dilation procedure; a rate of 0-12%(average approximately 3.4%) has Iloons 20 mm in diameter , but we stopped the procedure because the patient complained of severe chest pain. An esophagogram was taken and revealed a rupture of the distal esophagus.…”

Section: Resultsmentioning

confidence: 99%

Esophageal Achalasia: Results of Balloon Dilation

Kang

Yoon

et al. 1996

J Korean Radiol Soc

View full text Add to dashboard Cite

Purpose: To evaluate the clinical effectiveness of fluoroscopically guided balloon dilation in thetreatment of esophageal achalasia.Materials and Methods : Under fluoroscopic guidance, 21 balloon dilation procedures were performed in 14 patients with achalasia . A balloon with a diameter of 20 mm was used for the initial attempt. If the patient tolerated this welL the procedure was repeated with a 10-20mm balloon, placed alongside at the same session. If, however, the patient complained of severe chest pain and/or a postprocedural esophagogram showed an improvement, the additional balloon was not used. For patients whose results were unsatisfactory, the dilation procedure was repeated at sessions three to seven days apart.Results: Succesf 비 dilation was achieved in 13 of 14 patients(92.9% }, who needed a total of 20 sessions of balloon dilation , ranging from one to three sessions per patient(mean , 1.54 sessions). Esophageal rupture occured in one of 14 patients(7.1 %); of the 13 patients who underwent a successf비 dilation procedure, 12(92.3%) were free of recurrent symptoms during the follow -up period of 1 -56(mean , 18.5) months. The remaning patient(7.7%) had a recurrenceseven months after dilation.Conclusion: Fluoroscopically guided balloon dilation seems to be safe and effective in thetreatment ofesophageal achalasia.

show abstract

Section: Resultsmentioning

confidence: 99%

Esophageal Achalasia: Results of Balloon Dilation

Kang

Yoon

et al. 1996

J Korean Radiol Soc

View full text Add to dashboard Cite

show abstract

“…Six of these received scheduled dilation every 3-9 months. One hundred and fifteen dilations (range: [1][2][3][4][5][6][7][8] times/person) were performed in the 40 patients. 4 Long-term avoidance of surgery rate (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Endoscopic balloon dilation has been well documented for benign gastrointestinal stenotic lesions [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23], however, there are few reports concerning Crohn's stenosis [24][25][26][27][28][29][30][31][32][33]. Moreover, there is only one study which reported the long-term success rates or complications of endoscopic dilation [30].…”

Section: Introductionmentioning

confidence: 99%

Long‐Term Outcome of Endoscopic Balloon Dilation in Obstructive Gastrointestinal Crohn′s Disease: A Prospective Long‐Term Study

Matsui

Ikeda

Tsuda

et al. 1999

Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

Background The short-and long-term results of balloon dilation therapy in Crohn's patients with non-anastomotic obstructive gastrointestinal lesions are investigated.Materials and methods Fifty-five patients with Crohn's disease who had obstructive gastrointestinal lesions were treated prospectively by endoscopic balloon dilation.Short-term results Eight of the initial dilations were unsuccessful giving no symptomatic relief (14.5%).Long-term results The subjects of the long-term prognosis were 40 cases followed up for more than 6 months (average 37 months) and their strictures were non-anastomotic in more than half (59%). Avoidance of surgery, was possible in 31 of 40 patients (78%). Surgery was avoided in 92%, 81% and 77% of patients after one, two, and three years, respectively (Kaplan-Meier's method). There was no difference in long-term outcome between anastomotic strictures and strictures in the absence of prior surgery.Conclusion Our results suggest that, (1) strictures in the absence of prior surgery might be treated in this way as well as anastomotic strictures; (2) if followed for a prolonged time period, more than 70% of patients, who have undergone balloon dilation for obstructive gastrointestinal Crohn's disease, may be able to avoid surgery. of these underwent balloon dilation in our institute.All the procedures were performed by study members (T.M., S.T., K.Y. and S.S.) in a uniform procedure.Patients Thirty-two of the 55 patients were male. Age at the onset of gastrointestinal symptoms was ranged from 15 to 36 years (average 26.6). The diagnosis of Crohn's disease was confirmed endoscopically, radiographically or histologically. Before obstructive symptoms occurred, their disease had been followed for an average of 7.9 years (range 0.8-10.0). They were classified into 14 small intestinal (6 gastroduodenal), 34 ileocolitis, and 7 colitis type cases. At the time of dilation 32 (58%) had previously undergone surgery. Six patients had gastroduodenal stenoses and 49 patients had ileocolic stenoses. At the time of dilation 45 patients had mild to severe obstructive symptoms and 10 did not have obvious obstructive symptoms but had severe strictures which an endoscope was not able to pass through. These 10 patients had been recieving nutritional therapy (total parenteral nutrition or elemental diet) for active diseases for several weeks and were on nil by mouth. After disease activity had settled down to remission stage (CDAI < 150), colonoscopic evaluation revealed severe stenosis in these patients. They did not have obstructive symptoms because they had not ingest an ordinary diet yet. Seven of the ten asymptomatic patients turned out to be symptomatic during follow-up when on a regular diet. Indications for DilationIndications for balloon dilation were as follows:(1) patients who had strictures in gastroduodenal lesions or ileocolonic lesions, (2) the activity of the disease was quiescent (CDAI < 150, in 48) or not highly active (150 < CDAI < 250, in 7), (3) their general condition was not extremely p...

show abstract

“…Interestingly enough, two of our three perforations occurred after pneumatic dilatation in those patients who had previously been subjected to dilatations using both balloons and the Eder-Puestow instrument. If no increase in width of the stricture can be radiographically documented, another treatment might be contemplated, be it by using soft dilators (McLean et al, 1987), or surgery. A barium-swallow will also reveal any concomitant esophageal motor disturbance in still symptomatic patients successfully dilated.…”

Section: Discussionmentioning

confidence: 99%

“…The dilatation technique has been previously described (McLean et al, 1987). It was preceded by an endoscopic inspection including biopsies in order to establish the benign nature of the stricture.…”

Section: Methodsmentioning

confidence: 99%

Endoscopic Balloon Dilatation of Benign EsophagealStricture—A Nonhazardous Procedure?

Ekberg

Borgström

Fork

et al. 1994

Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

Balloon dilatation of benign esophageal strictures has been widely used since its introduction. We have performed 224 dilatation procedures in 52 patients. Dilatation was done as an outpatient procedure. Strictures were due to reflux esophagitis in 25 patients, anastomatic stenosis in 6, achalasia in 5, complications of sclerotherapy in 5, corrosive lesions in 3, and long-standing nasogastric intubation in 2. The cause was unknown in 6 cases. The intention was to dilate all strictures up to 20 mm. Three major complications occurred, and one of these patients died. The risk of perforation seems to be higher after repeated procedures than during the first one.

show abstract

Radiologically guided balloon dilation of gastrointestinal strictures. Part I. Technique and factors influencing procedural success.

Cited by 64 publications

References 0 publications

Esophageal Achalasia: Results of Balloon Dilation

Esophageal Achalasia: Results of Balloon Dilation

Long‐Term Outcome of Endoscopic Balloon Dilation in Obstructive Gastrointestinal Crohn′s Disease: A Prospective Long‐Term Study

Endoscopic Balloon Dilatation of Benign EsophagealStricture—A Nonhazardous Procedure?

Contact Info

Product

Resources

About